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Dr. Gregory Pais, ND
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Home arrow Naturopathic News arrow Issue #118 - July 2012
Issue #118 - July 2012
  1. INTRODUCTION
  2. PREVENTING CHRONIC DISEASE WITH VITAMIN D
  3. STEAM VALLEY FARM AT WILLIAMSPORT GROWER'S MARKET
  4. HOMEOPATHY 101 HOW HOMEOPATHY WORKS PART 2
  5. AUTOIMMUNE DISEASE AND GLUTEN
  6. WATER BETTER THAN REFLUX DRUGS
  7. ENDOCRINE DISRUPTORS IN HOUSEHOLD PRODUCTS
  8. VITAMIN D HELPS WITH ALZHEIMER'S DISEASE
  9. GETTING ANTIBIOTIC RESISTANT GERMS OUT OF PORK
  10. WEBSITE SERVICES
Welcome to this issue of Naturopathic News, issue #118. It's my mission to help you find optimal solutions to health problems. This newsletter is one way to do that. The more educated you are about your health options the better able you will be to take control of your health. If you would like to stop receiving my newsletter please send me an email and let me know. If you have a friend or family member who you think would appreciate the information provided, send me their email address. 


HERE COMES THE SUN
My eBook, "Here Comes The Sun: Preventing Chronic Disease With Vitamin D", is available for purchase.

The best way to order my book is to mail a check (made out to Dr. Pais) for $9.95 to my office address below. Drop me an email saying your "check is in the mail" and I will immediately email you my book.

I would appreciate any comments or feedback once you've finished reading it. Enjoy!


STEAM VALLEY FIBER FARM AT WILLIAMSPORT FARMER'S MARKET
Steam Valley Fiber Farm has begun their season at the Williamsport Grower's Market. You can find them there every Saturday. Featured products are their farm-raised Mohair, Wool Socks, Natural color Mohair yarns, Hand-dyed yarn, and Chorizo sausage. Visit this Saturday to watch the spinners turn wool into yarn on their spinning wheels.
For more info, email This e-mail address is being protected from spam bots, you need JavaScript enabled to view it


HOMEOPATHY 101
How Homeopathic Medicines Work Part 2
Last month in Naturopathic News #117 I presented the first part of how homeopathic medicines work. We look at the specific symptoms and signs of the sick person (natural disease). Then we select the most similar homeopathic medicine in potency (artificial disease). When this is given to the sick person the action of the weaker natural disease is extinguished by the stronger artificial disease. The artificial disease (homeopathic medicine in potency) soon plays itself out, leaving the patient recuperated.

In this way, the human organism is more susceptible to homeopathic medicines and therefore natural diseases are overcome. On the other hand, not everyone is susceptible to the same disease stimulus. Even in the same household someone won't get the cold or the flu that is being spread. We become diseased by them only when we are exactly and sufficiently disposed and laid open to be assailed by the cause of disease that is present. This then alters our condition, creating the resulting signs and symptoms. So the disease agents do not make everyone sick every time.

It is very different with the artificial disease substances which we call homeopathic medicines. Every homeopathic medicine works at all times, under all circumstances, on every living human being, and arouses in him its peculiar symptoms. These symptoms will be undeniable if the dose is large enough. Therefore, every living human organism must be affected throughout by the artificial disease which is, as mentioned above, not at all the case with natural diseases.  

The greater strength of the artificial disease that a medicine can produce is, however, not the only requirement for its being able to cure a natural disease. Above all, a medicine must be capable of producing an artificial disease as similar as possible to the disease to be cured. With its somewhat stronger energy, it will thus be able to displace the organism into a disease state very similar to the natural one. In this way it entirely extinguishes the natural disease. 


AUTOIMMUNE DISEASE AND GLUTEN  
You've probably heard the term autoimmune disease and may know someone that has an autoimmune disease like multiple sclerosis, rheumatoid arthritis, or others. What exactly does autoimmune disease mean and how does it develop? 

It all starts with the immune system. Our immune system is the indwelling function that keeps us healthy. That's its purpose, to protect us and keep us healthy. There are multiple branches of the immune system, each working in its own way to maintain health. 

One of the ways that the immune system gets activated to protect us is through what are called antibodies. Antibodies are gamma globulin proteins (IgA, IgE, IgG, IgM) that are found in blood and other body fluids. Like all proteins they are made up of building blocks called amino acids. When presented with a foreign or triggering substance (like gluten) the immune system responds by producing antibodies that specifically target that substance. These antibodies produce chemicals called cytokines that destroy the targeted substance-say the bacteria that causes tetanus. When all of the offending substance is gone the immune system turns off and those antibodies are no longer produced at that time. However, in the future, if presented with that same substance again, the immune system has already learned how to manufacture the antibodies that destroyed the bacteria or gluten, etc. We are surrounded by bacteria, viruses, yeasts, chemicals, and other harmful substances. A competent immune system learns how to deal with these triggers over time. If a healthy lifestyle is in place-air, water, food, exercise, stress-then the frequency and severity of illness is greatly reduced by the immune system.

Autoimmune disease is when the body makes antibodies against its own tissue. In the case of Type 1 diabetes, the body is produced antibodies that destroyed the beta cells in the pancreas--the cells that produce insulin. In the case of multiple sclerosis antibodies thin out and erase the myelin sheath-the fatty protective layer that surrounds nerve tissue. With autoimmune thyroiditis it's the cells of the thyroid gland. All autoimmune diseases have similar mechanisms of action in that antibodies target the body's own cells or tissue. 

How does it end up happening that the body starts attacking itself? Say that a person has a sensitivity to the food gluten due to a gene or over consumption. Gluten is a protein found in wheat, rye, barley, spelt, kamut, and teff. The body produces anti gluten (anti gliadin) antibodies and these circulate through the blood stream. Your blood carrying these anti gluten antibodies moves past every tissue in the body. It will flow past the myelin sheath that protects the nerves for example. Remember, antibodies are made up of the building blocks called amino acids.

Let's say there is a sequence of amino acids in gluten, AAGGCC. When the body makes antibodies to the protein gluten these antibodies produce the cytokines to destroy gluten. They recognize gluten by the amino acid sequences that make up the protein. The antibodies search out AAGGCC anywhere in the body and destroy it. The cells of the myelin sheath are made up of proteins and fats. If there is the amino acid sequence AAGGCC present in the myelin cells that's the same amino acid sequence the body has targeted with the anti gluten antibodies. With over consumption of gluten, unhealthy digestive tracts from antibiotics, steroids, and other drugs, damage from chemicals, pesticides, and endocrine disruptors like BPA, the immune system is over reactive and the anti gluten antibodies end up attacking the myelin cells because of the AAGGCC sequence. All it takes is 6 or more amino acids in sequence and the similarity makes it possible that the body will attack its own tissue. This process is the same for any of the autoimmune diseases, not just the myelin (multiple sclerosis).

So the body attacks its own tissue and the myelin gets damaged. It's a normal part of physiology to repair damaged tissue anywhere in the body, often by producing antibodies. There is a normal amount of anti myelin antibodies present at any time. As well as other tissue focused antibodies. When you have elevated levels you have an autoimmune condition going on. 

In our example, the anti gluten antibodies have attacked the myelin because they thought it was gluten. The myelin cells have been damaged because of that. Now the immune system has to make anti myelin antibodies to clean up the damaged cells. That wouldn't be a major problem except for the fact that we eat so much gluten-breakfast pancakes, sandwich for lunch, pasta for dinner, cookies for dessert. We end up making so many antibodies that damage so much tissue, day after day, month after month, year after year. Until, even if you've stopped eating gluten, the body continues to make these anti myelin antibodies. You don't need to continue eating gluten for the damage to the myelin, the thyroid, the intestine, the muscle, etc., to continue. Even the crumb from a crouton that was in your salad is sufficient to trigger antibody production for up to 2 weeks. And these antibodies last from 4-6 weeks, causing damage throughout that time. This is the basic mechanism by which autoimmune disease occurs.

Gluten has been the food most studied so far but dairy is probably right up there with it in terms of frequency and harm caused. Dairy itself has been implicated, by this very mechanism, in Type 1 diabetes. The molecular structure of the protein cells in dairy is very similar to the beta cells in the pancreas. Studies have shown that avoiding dairy in the first year of an infant's life helps t prevent diabetes onset.

As the immune system in the gut develops in the growing child it learns to tolerate what comes in from the outside world. Organic apples good, bacteria on factory raised chicken bad. The immune system learns to differentiate friendly from the enemy. As we grow and are exposed to environmental toxins-radiation, heavy metals, endocrine disruptors, pesticides, and everything else, our immune systems are over worked. Eventually we cross our reactive threshold and start reacting to foods that 'never used to bother me'. They actually always did; you just never noticed, drugged away the symptoms, or ignored them.

This is how you can start having a problem with gluten after decades of eating it. Your immune system has been so abused, has worked so hard to keep you healthy, that it can't take it any more. It's lost the ability to tolerate the abuse. And then you get symptoms. So the foods that you have been eating multiple times per day-wheat, dairy-cause antibodies to be produced and this whole disease mechanism is triggered.

Can you ever eat these foods again? The one answer you will hear is that, in the case of celiac disease, it's permanent. What you have to realize is that, in all the studies that have been done is that all these people did was stop eating gluten. They didn't change their lifestyle. They didn't address other food triggers. They didn't heal their gut. They didn't reduce their stress. They didn't greatly reduce their exposure to chemicals, endocrine disruptors, pesticides, etc. In other words, they didn't change their lifestyle and take a comprehensive approach to their health. 

Take 1 month, or 3 months, or 6 months and change your lifestyle. If you feel better not eating gluten, not eating dairy, then why start back on these foods and possibly start the whole process all over again? It's a pretty strong motivator to feel good when you've created the best lifestyle for yourself.


WATER MORE THERAPEUTIC THAN ACID REFLUX DRUGS
In 2008, a remarkable study took place comparing a glass of water to an antacid and "acid blocking" drugs, in their overall effect in increasing gastric pH (i.e. making it more alkaline) in healthy subjects.  

Researchers took 12 healthy subjects and gave them a single oral dose of the following agents:
* A glass of water (200 ml)
* Antacid
* Ranitidine (Zantac)
* Omeprazole (Prilosec/Losec)
* Esomeprazole (Nexium)
* Rabeprazole (AcipHex)

Gastric pH was recorded for six hours after drug intake.
The study found it took the following duration to increase pH >4:
* Water increased pH >4 in 10/12 subjects after 1 minute
* Antacid increased pH >4 in 2 minutes
* Rantidine increased pH >4 in 50 minutes
* Omeprazole increased pH >4 in 171 minutes
* Esomeprazole increased pH >4 in 151 minutes
* Rabeprazole increased pH >4 in 175 minutes  
"A glass of water immediately increases gastric pH in healthy subjects." Dig Dis Sci. 2008 Dec;53(12):3128-32. Epub 2008 May 13
DR. PAIS'S COMMENTS:
What would you rather do? Get instant relief with a glass of water, which has positive side benefits to your health, or wait between 50 minutes to 175 minutes (almost 3 hours) as the excess acid burns the lining of your stomach, using a chemical class of drugs which have the potential to cause the following unintended side effects:

1. Clostridium Infections
2. Diarrhea
3. Pneumonia
4. Vitamin C Deficiency
5. Gastric Cancer
6. Bone Fractures
7. Magnesium Deficiency
8. Muscle pain
9. Vitamin B12 Deficiency

Of course, water will only dilute a problem that is often a direct result of bad food choices, excessive portions, acute or chronic stress, undiagnosed overgrowth of pathogens, and food or environmental toxins, to name but a few known contributing factors. But, water does do no harm, whereas using chemical drugs to poison cells in the stomach into shutting down acid production has an obvious set of serious side effects that can and should be avoided, whenever possible.


ENDOCRINE DISRUPTING CHEMICALS IN MANY HOUSEHOLD PRODUCTS
Tests of more than 200 common household products found that the products contain chemicals that research suggests may be linked to asthma and hormone disruption, researchers report.

Products tested included a wide range of household products, such as soaps, lotions, detergents, cleaners, sunscreens, air fresheners, kitty litter, shaving cream, vinyl shower curtains, pillow protectors, cosmetics and perfumes.

Researchers identified 55 chemicals that studies have shown may have health consequences. Among the chemicals detected were various types of phthalates, which have been linked to reproductive abnormalities and asthma; bisphenol A (BPA), and parabens, which some research suggests may mimic estrogen in the body and have been associated with breast cancer.

"This is the first large, peer-reviewed study looking at hormone-disrupting and asthma-related chemicals in a wide range of consumer products," said study author Robin Dodson, a research scientist at the Silent Spring Institute in Newton, Mass.

The chemicals, however, were not listed on the product labels, which included major brand-name products as well as those "alternative" products marketed by the same companies. These are often described as fragrance-free, more natural and safer than conventional products.

One or more of the chemicals turned up in all of the conventional product samples tested. For each of the categories of conventional products, researchers included several brands. For example, the floor cleaner sample included Spic and Span, Swiffer WetJet Multi-Purpose Cleaner and Stop & Shop Pine Oil Cleaner Disinfectant, while the laundry detergent category included several brands sold by Procter & Gamble, Unilever, Foodhold USA and Church & Dwight, the study authors said.

The study highlights the need for more complete labeling so that consumers know what they're being exposed to, Dodson said. "These results show we are exposed to a wide range of chemicals of concern in everyday products, and the chemicals aren't always listed on the labels," she said. "That can be a basis for modernizing our chemical policy in the United States. It seems these chemicals are not being adequately tested before being put on the shelf."
"Endocrine Disruptors and Asthma-Associated Chemicals in Consumer Products," is published in the March 8 2012 online edition of Environmental Health Perspectives.
DR. PAIS'S COMMENTS: Often with these kinds of reports the companies that make these products will claim they are safe and there's no proof behind the findings so you should sill buy what they're selling. Basically meaning that we are the guinea pigs that test these products and get sick from using them years later. Wouldn't it be interesting to put the burden of proof on the manufacturers? Prove your products don't cause health problems, and then you can sell them.

Silent Spring offers some tips to choose better products, including:
* choosing products that are plant-based,
* using water, baking soda and vinegar for cleaning,
* wearing hats and cover-ups instead of relying only on sunscreen for sun protection,
* steering clear of cleaning and other products that contain fragrance,
* avoiding vinyl pillow and mattress protectors,
* choosing lotions, deodorants and shampoos that are paraben-free.

Antimicrobial soaps also contain chemicals such as triclosan and triclocarban, which are also chemicals of concern regarding asthma and endocrine disruption, Dodson noted.


VITAMIN D MAY HELP WITH ALZHEIMER’S
A team of researchers has identified the intracellular mechanisms regulated by vitamin D3 that may help the body clear the brain of amyloid beta, the main component of the damaging brain plaques associated with Alzheimer's disease.

Early findings show that vitamin D3 may activate key genes and cellular signaling networks to help stimulate the immune system to clear the amyloid-beta protein. 
Previous laboratory work by the team demonstrated that specific types of immune cells in Alzheimer’s patients may respond to therapy with vitamin D3 and curcumin, a chemical found in turmeric spice, by stimulating the innate immune system to clear amyloid beta. 

“This new study helped clarify the key mechanisms involved, which will help us better understand the usefulness of vitamin D3 and curcumin as possible therapies for Alzheimer’s disease,” said study author Dr. Milan Fiala, a researcher at the David Geffen School of Medicine at UCLA and the Veterans Affairs Greater Los Angeles Healthcare System.

For the study, scientists drew blood samples from Alzheimer’s patients and healthy controls and then isolated critical immune cells from the blood called macrophages, which are responsible for gobbling up amyloid beta and other waste products in the brain and body.  

The team incubated the immune cells overnight with amyloid beta. An active form of vitamin D3 was added to some of the cells to gauge the effect it had on amyloid beta absorption. “Our findings demonstrate that active forms of vitamin D3 may be an important regulator of immune activities of macrophages in helping to clear amyloid plaques by directly regulating the expression of genes, as well as the structural physical workings of the cells,” said study author Mizwicki. 

According to the team, one of the next stages of research would be a clinical trial with vitamin D3 to assess the impact on Alzheimer’s disease patients. Previous studies by other teams have shown that a low serum level of Vitamin D3 may be associated with cognitive decline.
March 6 2012 Journal of Alzheimer’s Disease
DR. PAIS'S COMMENTS: The basic idea behind this work is that Vitamin D helps to clear away the substances in the brain that are responsible for Alzheimer's Disease. This is not a drug, this is a vitamin. So though people should be followed with Vitamin D testing to track response and effectiveness, there is really no reason why a practitioner thoroughly trained in nutrition in medical school (naturopaths, some chiropractors, and some nutritionists) couldn't pursue this with their patient population.


GETTING ANTIBIOTIC-RESISTANT BUGS OUT OF PORK
After nearly succumbing to an antibiotic-resistant infection contracted from one of his hogs, Russ Kremer went cold turkey. He exterminated his diseased pigs and swore off the antibiotics he'd long-used to boost his herd's growth and prevent the illnesses so common in concentrated animal feeding operations, or CAFOs.

Now, more than 20 years later, he says his farm is organic, sustainable, humane and still nearly as efficient as the typical industrial CAFO. Plus he's eliminated the $16,000 a year he used to spend on veterinary and drug bills. And he hasn't sacrificed his pigs' health in the process. If anything, the opposite is true for Fred, Barney, Wilma, Pebbles, Bamm-Bamm and the other 500-some pigs that roam his 150-acre farm.

"My mortality rate is less than 1% after they leave their mother. In the industry, many people are seeing a 5% to 10% loss," 

"We've worked our way into a pickle," said David Wallinga, a senior adviser at the Institute for Agriculture and Trade Policy. The more antibiotics we use, the more microbes become resistant to those drugs -- even to our "biggest guns." It's a microscopic survival of the fittest.

Wallinga and his colleagues recently found drug-resistant microbes in 65% of about 400 pork products sampled from a dozen grocery stores across Iowa, Minnesota and New Jersey. Nearly 7 percent of the products had measurable amounts of MRSA, according to their study, published in January 2012 in the journal PLoS ONE.

"We find antibiotic resistance genes quite prevalent in all pigs, irrespective of antibiotic feeding. We think this may be partially due to the fact that at least in pig growing regions, the background flora that they pick up is already enriched with antibiotic resistance genes," said James Tiedje, a microbiologist at Michigan State University and researcher on the study.

Kremer is well aware that antibiotic residue can persist in the environment and lead to resistance long after the last dose of antibiotics was used on that land. Fortunately, he set up his new operation on land that -- as far back as he's aware -- had only been used for organic farming. And he made every effort not to introduce any bad bugs or drugs, including bringing in only piglets that had been born via cesarean section.
DR. PAIS'S COMMENTS: Kremer's story exemplifies the findings of a growing number of scientific studies on the effects of antibiotic use in livestock. 29 million pounds of antibiotics are given to livestock every year -- about four times the amount consumed by people, and mostly used at sub-therapeutic doses -- appears to be contributing to a rise in drug-resistant infections in both animals and people. The most infamous of the microbes: methicillin resistant Staphylococcus aureus, better known as MRSA.
 

WEBSITE SERVICES
Here are some pages that are of particular interest:

Store: There are 350 products from Emerson listed on this page. If yours isn’t one of them please let me know and I will add it so you can order online. This is particularly convenient after hours or on the weekend. Of course, you can always order by phone from Emerson at 800-654-4432.

Newsletter: Here you will find all 116 issues of my health newsletter, "Naturopathic News”.

Optimal Health Points: This is my blog that I update periodically. Check out my latest post, “No Deaths From Vitamins, Minerals, Amino Acids Or Herbs”.


FACEBOOK
Come join my fan page at www.facebook.com/NaturalDoc 
Help me bring information, news, and stories about natural medicine to the Facebook community. 

For those of you who don’t know, Facebook is a social networking website. Users can add friends and send them messages, and update their personal profiles to notify friends about themselves. Additionally, users can join networks organized by city, workplace, and school or college. 

Facebook pages help you discover new artists, businesses, and communities as well as those you already love. On my fan page www.facebook.com/NaturalDoc I post discussions that you can join in with and relay breaking health news related to disease prevention, clinical nutrition, and ways to make you healthier. 

I’m looking forward to exploring this community with you. See you there!


LET ME HELP YOU MAKE WISE SUPPLEMENT CHOICES
As is often the case, a recent new patient asked if I would review their choice and use of supplements and herbs. Why does this happen so often? For many, taking a vitamin or herb is their introduction to natural medicine. Their desire to be healthier drives them to take supplements and herbs. The death, pain, discomfort, and side effects experienced with over the counter and prescription drugs compel people to look elsewhere. It’s very different with supplements and herbs which, when used correctly, have an incredibly low risk of harm.

Some people take this to an extreme and take every supplement or herb that someone tells them is ‘good for them’. It might be a clerk, an internet ‘expert’ source, or a friend who is marketing the latest or greatest fad. Most of these individuals or companies have no professional training or experience in the medical use of the supplements or herbs that they’re selling. The people they’re selling to come into my office with 5, 10, 15, or more supplements that they’re taking. Sometimes it’s been so long since they started taking them that they don’t remember why they’re doing it. When I ask, they can’t tell me what, if anything, a particular product is doing for them. Yet, they can be quite fearful of stopping any of these items, as if their health would careen off a precipice without them.

Why do I think my approach is any different? Partly, it’s because of my background. I’ve literally been working with nutritional supplements since 1974. That’s 36 years assessing the quality and effectiveness of supplements. Beginning in 1980 I started working with Western and Chinese herbs. The quality of herbs used and how they’re combined together has the greatest effect on the efficacy of the final product. Because I’ve grown, identified, harvested, and produced medicinal herbal products I recognize a good formula when I see one.

Licensed naturopaths like me receive the most extensive academic and clinical training in the use of nutritional supplements and herbal medicines of any professional in the United States. Nothing can substitute for such hands on experience, especially when you see, and are responsible for, the results of your treatments. Very different from the clerk in the store, or coworker who’s part of a MLM scheme. 

What I’m offering to is easy access to this experience and training. Both for you and your family. If you have questions about the supplements or herbs you are taking, or are thinking about taking, now is the time to ask. Send me an email with the brand and name of the product you’re taking. Let me know that you want to bring the bottles in at your next visit, so I can see what you’re taking. Start a discussion on my Facebook fan page. Either way I’ll give you honest feedback about what I think is good, or what isn’t. We’ll fine tune what you’re taking to maximize effect and eliminate waste. 

Let me hear from you and we’ll get started. 


GET YOUR VITAMIN D TEST WITH ZRT LABORATORY
It just happened again the other day. A patient sent me a copy of the Vitamin D test she just had done. With frustrating results. The wrong test was done. After all these years, and all the information available, MDs and laboratories still order the wrong test. What a waste of money and time. 

For a long time I looked for a home Vitamin D test. One that would be simple, easy, and accurate to do on your own. I finally found one. ZRT Laboratory in Beaverton OR. ZRT emphasizes research and technological innovation. 

Until now, venipuncture blood serum has been the standard medium for testing Vitamin D. ZRT has developed and refined Vitamin D testing in blood spots. A few drops of blood from a quick and nearly painless nick of the finger, placed on a filter paper to dry are all that is needed. The total 25 (OH) Vitamin D is then determined by liquid chromatography/tandem mass spectrometry (LC-MS/MS). This method has been shown to be as accurate as the assay standard.

Ordering A Vitamin D Test 
ZRT allows anyone to order a Vitamin D test kit for $95 plus shipping and have it sent to their home. ZRT will let me prepay for kits and send them to my office for $55 each, plus $8 shipping. I am charging $65 per kit for patients to cover the total. 

If you are interested in getting a Vitamin D test done through my office please prepay so I can order you a kit. Then you can either pick it up at my office or have it shipped to your home. Once you’ve taken the sample and sent it back to ZRT it’s only a matter of time before your results are sent back to me. I can even look at them online before the mail arrives.

If your doctor has refused to order a Vitamin D test or worse, ordered the wrong one, this is the fastest, least expensive, most accurate way to do it ourselves. Once we know what your Vitamin D levels are, the next step is making sure that you achieve optimum levels for prevention of disease and maintenance of health.


EMERSON ECOLOGICS
I am often asked what supplements I recommend. Many of you have been surprised to discover that I favor food over pills; lifestyle changes over fads. I have been working with nutrition for over 30 years, herbs for over 20 years. Where and when appropriate I recommend them to my patients. I strive to act from knowledge, experience, and research.

Emerson Ecologics (800-654-4432) carries almost all of the nutritional supplements and botanical extracts that I think are useful. Their customer service is excellent and their delivery is reliable (often only 2-3 days to this region). It’s a great way to get physician quality products at reasonable prices. 

To offset the cost of shipping, reference my name when you establish your account and receive a 10% discount on every order. If you have any questions about these items feel free to email me.

That’s it for this issue of Naturopathic News. If you’ve thought a bit extra or learned something new, then I achieved my goal. As usual, if you have questions or concerns brought up by these subjects, let me know. 

Gregory Pais, ND, DHANP
580 E. 3rd. St.
Williamsport PA 17701
570-320-0747 
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